Disparities/Minority Health

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Studies have consistently documented racial and ethnic disparities in health and health care. According to a recent report from the Institute of Medicine, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health
Care, there is unambiguous evidence that even after adjusting for insurance coverage, members of racial and ethnic minorities receive care inferior to their white counterparts.

The Agency for Healthcare Research and Quality is part of a coordinated, multifaceted effort across the Department of Health and Human Services to understand and eliminate racial and ethnic disparities in health and health care. AHRQ's research focuses on the contribution of disparities in health care to observed disparities in health. The Agency's efforts are summarized in a recent commentary by AHRQ's Daniel Stryer, M.D., Carolyn Clancy, M.D., and Lisa Simpson, M.B., B.Ch., M.P.H.

As part of a 5-year effort begun in 2000, AHRQ, in partnership with other agencies and foundations, provided $45 million to fund nine Excellence Centers to Eliminate Ethnical/Racial Disparities (EXCEED). EXCEED sites focus on a variety of issues to reduce disparities. These include the quality of diabetes care provided to American Indians (who have a high rate of diabetes), factors that impede doctor-patient communications, and development of strategies to improve cultural competency among health care providers and enhance access to care for particularly vulnerable subgroups, such as those who are chronically ill and rural patients. Each EXCEED site has assembled a critical mass of investigators, policymakers, analysts, and community representatives to generate knowledge that can be rapidly and widely implemented to reduce racial/ethnic disparities.

Through its Translating Research into Practice II (TRIP II) initiative, AHRQ will provide more than $10 million over the next 3 years to support six studies that aim to close the gap between research and clinical practice. One such study is developing and evaluating the effectiveness of interactive technology to overcome barriers to diabetes education for inner city blacks and Hispanics. Other programs being developed to augment research to improve the health of underserved and vulnerable populations are the practice-based research networks, the Minority Research Infrastructure Support Program, and the Agency's Office for Priority Populations Research, which will coordinate AHRQ-wide efforts to eliminate disparities for priority populations. In 2003, AHRQ will publish the first National Healthcare Disparities Report on behalf of the Department of Health and Human Services.